Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage
Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage
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DOI：
10.1186/s40478-020-01024-2
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发表时间：
2020-08-26
影响因子：
7.1
通讯作者：
Canoll, Peter
中科院分区：
文献类型：
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作者：
Al-Dalahmah, Osama;Thakur, Kiran T.;Canoll, Peter
我们记录了一名73岁的男性在相对轻度的SARS-CoV 2感染的情况下死于急性小脑出血的神经病理学结果。患者在入院当天突然出现头痛、恶心和呕吐，随后立即失去意识。紧急医疗服务发现他在家中严重低氧血症，病人在送往急诊室的途中心脏骤停。急救小组在超过17分钟的复苏后恢复了自主循环。胸片显示双侧混浊;鼻咽拭子SARS-CoV-2实时PCR呈阳性。头部计算机断层扫描显示右侧小脑大出血，伴扁桃体疝和脑室内出血。发病后一天，他被转入舒适护理，并在姑息性拔管后不久死亡。死亡后3小时进行的尸检显示小脑出血和脑桥背侧和延髓急性梗死。值得注意的是，有小胶质细胞结节和神经元吞噬双侧下橄榄和多灶性小脑齿状核。到目前为止，在SARS-CoV-2感染的背景下，尚未报告这一系列发现。
We document the neuropathologic findings of a 73-year old man who died from acute cerebellar hemorrhage in the context of relatively mild SARS-CoV2 infection. The patient developed sudden onset of headache, nausea, and vomiting, immediately followed by loss of consciousness on the day of admission. Emergency medical services found him severely hypoxemic at home, and the patient suffered a cardiac arrest during transport to the emergency department. The emergency team achieved return of spontaneous circulation after over 17 min of resuscitation. A chest radiograph revealed hazy bilateral opacities; and real-time-PCR for SARS-CoV-2 on the nasopharyngeal swab was positive. Computed tomography of the head showed a large right cerebellar hemorrhage, with tonsillar herniation and intraventricular hemorrhage. One day after presentation, he was transitioned to comfort care and died shortly after palliative extubation. Autopsy performed 3 h after death showed cerebellar hemorrhage and acute infarcts in the dorsal pons and medulla. Remarkably, there were microglial nodules and neuronophagia bilaterally in the inferior olives and multifocally in the cerebellar dentate nuclei. This constellation of findings has not been reported thus far in the context of SARS-CoV-2 infection.